The Neighbourhood Effects on Health and Well-being (NEHW) study

Abstract

Many cross-sectional studies of neighbourhood effects on health do not employ strong study design elements. The Neighbourhood Effects on Health and Well-being (NEHW) study, a random sample of 2412 English-speaking Toronto residents (age 25-64), utilises strong design features for sampling neighbourhoods and individuals, characterising neighbourhoods using a variety of data sources, measuring a wide range of health outcomes, and for analysing cross-level interactions. We describe here methodological issues that shaped the design and analysis features of the NEHW study to ensure that, while a cross-sectional sample, it will advance the quality of evidence emerging from observational studies.

Current stress and poor oral health

“…All participants provided written informed consent at the time of their interview and were compensated $50 for their participation. As described elsewhere in more detail, a three stage sampling strategy was employed to randomly sample households within a random sample of census tracts and neighbourhood planning areas in the City of Toronto [23]. …”

“…Participants were eligible for the study if they were able to communicate in English, were between the ages of 25–64 years old, lived in their neighbourhood for at least 6 months, and were a resident of the home. Further details on study procedures can be obtained elsewhere [23]. …”

“…The NEHW study collected data on neighbourhood and individual level factors that promote or diminish mental health using same-room face-to-face surveys in a total of 2,412 participants (response rate of 72 %; [24]) living in a random sample of 47 neighbourhoods throughout Toronto [23]. The survey included two self-rated oral health questions utilized as dependent variables in this analysis.…”

“…Sampling weights were derived previously [23] and utilized in all analyses to correct for any selection biases by comparing the distribution of sample characteristics using 2006 Census data for the City of Toronto.…”

Mental health services use among adults with or without mental disorders: Do development stages matter?

“…poverty, unemployment) that erodes mental health, disintegrate social cohesion by discouraging residents in participating in neighbourhood activities and increase exposure to crime and violence, leading to feelings of fear, mistrust and psychological distress (Kim, 2010;Polling, Khondoker, SELCoH study team, Hatch, & Hotopf, 2014). As previously reported, neighbourhood problems are correlated with depression and anxiety, while social cohesion is inversely associated with these disorders (O'Campo et al, 2015). Living in a disordered neighbourhood may enhance needs, leading to MHS use in the absence of social support within communities (Hill & Maimon, 2013).…”